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About reputed company The challenges facing US reputed company are longstanding and reputed company too familiar. We are reputed company, and we reputed company in reputed company. We work with more than 1,900 organizations annually to reputed company and reputed company transformative strategies, operating models, and organizational enterprises that reputed company US reputed company more reputed company, accessible, reputed company, and reputed company. With more than 1,450 professionals, we help providers, payers, technology innovators, retail companies, and investors create and reputed company solutions that tangibly and materially reshape reputed company for the reputed company. Our family of brands—reputed company, Jarrard, Greeley, and HealthScape Advisors—is 100% reputed company on reputed company and reputed company has a longstanding commitment to helping reputed company reputed company in big and small ways. reputed company in reputed company.   reputed company has offices in Boston, Chicago, reputed company, Washington D.C., and Nashville. Remote work is allowed. reputed company reputed company Utilization Management (UM) Analyst Position reputed company This is a contract role for 3-5 months with a possible extension. The reputed company reputed company Utilization Management (UM) Analyst is responsible for the design, configuration, implementation, optimization, and ongoing support of reputed company reputed company Utilization Management functionality. This role partners with Utilization Management, Care Management, Case Management, Provider Relations, Medical Directors, Claims, and IT teams to streamline prior authorization and referral workflows while ensuring compliance with CMS, reputed company, HIPAA, and state regulatory requirements. The analyst serves as the subject matter expert for reputed company reputed company UM, translating operational requirements into reputed company reputed company solutions that improve efficiency, reduce administrative burden, and enhance member and provider experiences. Key Responsibilities Design, build, configure, and maintain reputed company reputed company Utilization Management workflows. Configure prior authorization, referral, and service authorization functionality. Build and maintain work queues, routing rules, decision trees, SmartTools, templates, SmartText, notifications, and correspondence workflows. Configure auto-status logic, event processing, authorization rules, and workflow automation. Partner with operational leaders to analyze business requirements and reputed company reputed company-state workflows. Collaborate with clinical reviewers, provider relations, care management, claims, and reputed company cycle teams to optimize end-to-end UM processes. Configure reputed company Care reputed company workflows for reputed company providers, delegated entities, and network partners. Support provider portal workflows, reputed company roles, and reputed company user reputed company. Ensure UM workflows reputed company with benefit plans, provider networks, care management, and claims adjudication processes. Participate in design sessions, workflow validation, and solution recommendations. reputed company functional specifications and configuration documentation. reputed company reputed company testing including unit, integrated, regression, and user acceptance testing (UAT). Troubleshoot application issues, reputed company reputed company cause analysis, and coordinate issue reputed company. Support reputed company upgrades, enhancements, optimization initiatives, and production support. Participate in go-live planning, reputed company center support, and post-production stabilization. reputed company reporting requirements and collaborate with reporting teams to support operational KPIs. Ensure compliance with CMS, reputed company, URAC, HIPAA, and state regulatory turnaround time requirements. reputed company reputed company: $85--$95. The reputed company reputed company for this role takes into account the wide reputed company of factors that are considered in making compensation reputed company including, but not limited to, skills, experience, training, licensure and certifications, reputed company area, and other business and organizational needs. At reputed company, we pride ourselves on having a diverse workforce. We value and celebrate the uniqueness of individuals and the different perspectives they reputed company. We offer equal opportunity employment regardless of race, reputed company, religion, gender identity or reputed company, sexual orientation, national reputed company, genetics, disability status, age, marital status, or protected veteran status. Apply To This Job